Detection and dissection of sentinel nodes in endometrial endometrioid cancer with indocyanine green using PinPoint laparoscopy: Analysis of the learning curve.

Objective: Early-stage endometrial endometrioid adenocarcinoma is managed through laparoscopic total hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy. Detection of positive nodes is rare, and lymphadenectomy may involve complications. Pelvic sentinel lymph node dissection can prevent complete dissection.

Rate of hourly change in serum beta-human chorionic gonadotropin levels in ectopic pregnancy can predict the success of treatment with single-dose methotrexate: A retrospective observational study.

Objective: To determine whether the success of treatment with single-dose methotrexate (SD MTX) for ectopic pregnancy can be predicted using the rate of change in serum β-human chorionic gonadotropin (β-hCG) level.

Study Design: This was a retrospective observational study conducted at a tertiary referral centre. The study population included women who underwent treatment with SD-MTX for ectopic pregnancy.

Coexisting Epithelioid Trophoblastic Tumor and Placental Site Trophoblastic Tumor During Asymptomatic Relapse: A Case Report and Literature Review.

Gestational trophoblastic neoplasms are a group of trophoblastic tumors that include choriocarcinoma (CC), epithelioid trophoblastic tumors (ETTs), and placental site trophoblastic tumors (PSTTs). Mixed gestational trophoblastic neoplasms include combinations of CCs with ETTs and/or PSTTs; combinations of ETTs and PSTTs have also been described. This report describes the case of a 49-yr-old female with mixed ETT and PSTT discovered due to menstrual delay and a positive beta-human chorionic gonadotropin in serum 11 yr after normal pregnancy; it is an asymptomatic recurrence of the neoplasm after 2 yr.

Angiotensin II Infusion for Shock: A Multicenter Study of Postmarketing Use.

Background: Vasodilatory shock refractory to catecholamine vasopressors and arginine vasopressin is highly morbid and responsible for significant mortality. Synthetic angiotensin II is a potent vasoconstrictor that may be suitable for use in these patients.

Research Question: What is the safety and effectiveness of angiotensin II and what variables are associated with a favorable hemodynamic response?

Study Design And Methods: We performed a multicenter, retrospective study at five tertiary medical centers in the United States.

Early prediction of methotrexate treatment outcome in tubal ectopic pregnancy based on days 0 and 4 human chorionic gonadotropin levels.

Aim: Methotrexate (MTX) is an efficient treatment for ectopic pregnancy, used according to 'single-dose' protocol. Treatment success is evaluated on days 4 and 7 after dose administration, and defined as a decline of ≥15% in beta-human chorionic gonadotropin (β-hCG) levels, with a positive predictive value of 93%. A decrease on day 4 β-hCG levels was determined to be a good predictor for treatment success.

Pregnancy of Unknown Location: The Value of Frozen Section Analysis and Its Relation to Beta-hCG Levels and Endometrial Thickness.

Objective:  Frozen section examination is a rapid method for identifying products of conception in endometrial curetting, yet its accuracy is inconclusive. The purposes of this study is to determine the accuracy of frozen section analysis of endometrial curetting in pregnancies of unknown location, and to verify the relation of β-human chorionic gonadotrophin (hCG) level and endometrial thickness to the assessed accuracy.

Methods:  We reviewed data from January 2009 to December 2014 of diagnostic curettages from women with suspected ectopic pregnancies sent for frozen section examination at a medical center.

Symptomatic pelvic accessory spleen in a female adolescent: Case report.

Accessory spleens are congenital foci of healthy splenic tissue that are separate from the main body of the spleen. They occur in 10-30% of individuals; a wandering accessory spleen located in the pelvis is uncommon. Most patients are asymptomatic.

Mitochondrial Replacement Therapy: Halachic Considerations for Enrolling in an Experimental Clinical Trial.

The transition of new biotechnologies into clinical trials is a critical step in approving a new drug or therapy in health care. Ethically recruiting appropriate volunteers for these clinical trials can be a challenging task for both the pharmaceutical companies and the US Food and Drug Administration. In this paper we analyze the Jewish halachic perspectives of volunteering for clinical trials by focusing on an innovative technology in reproductive medicine, mitochondrial replacement therapy.

Early versus late misoprostol administration after mifepristone for medical abortion.

Purpose: To evaluate the successful medical termination of pregnancy comparing two regimens: misoprostol 2 or 48 h after mifepristone administration.

Design: Prospective randomized study.

Setting: Department of Obstetrics and Gynecology.

Prediction of abortion using three-dimensional ultrasound volumetry of the gestational sac and the amniotic sac in threatened abortion.

Purpose: To determine whether gestational sac volume (GSV) or amniotic sac volume (ASV) and/or the difference between them can predict abortion in women with first-trimester threatened abortion.

Methods: Ninety patients between 6 and 12 weeks of gestation presenting with vaginal bleeding were studied. Seventy-six delivered after 24 weeks of gestation (group A) and 14 aborted before 20 weeks of gestation (group B).

The effect of parity and gravidity on the outcome of medical termination of pregnancy.

Background: Previous pregnancies may influence the success of medical termination of pregnancy.

Objectives: To determine the effect of parity and gravidity on the successful termination of pregnancy using mifepristone and misoprostol.

Methods: The medical files of all patients attending a department of obstetrics and gynecology during the years 2006 and 2007 for the purpose of medical termination of pregnancy at < or = 49 days of gestation were analyze retrospectively.

Early pregnancy failure: factors affecting successful medical treatment.

Background: The results of medical treatment for early pregnancy failure are conflicting.

Objectives: To determine whether gestational sac volume measurement as well as other variables can predict the success rate of medical treatment for early pregnancy failure.

Methods: The study group comprised 81 women diagnosed with missed abortion or anembryonic pregnancy who consented to medical treatment.

Gestational sac volume in missed abortion and anembryonic pregnancy compared to normal pregnancy.

Purpose: To compare gestational sac (GS) volume (GSV) between normal pregnancies and missed abortions and anembryonic pregnancies and to determine at what gestational age differences in GS volume become evident. METHODS.: GSV in missed abortion and anembryonic pregnancy were measured using three-dimensional ultrasound and the results were compared with GSV in normal pregnancies.

[Vestibulodynia--the Israeli experience].

The cause of vestibulitis, currently known as vestibulodynia, is still an enigma. Among those attempting to decipher the puzzle, Israeli researchers are well represented. This article reviews the developments in terminology, etiology, treatment, and research directions, with an emphasis on the role of IsraeLi research.

Peripheral polymorphonuclear leukocyte priming contributes to oxidative stress in early pregnancy.

Objective: The cause of elevated blood leukocyte count in pregnancy is unknown. We hypothesized that priming of peripheral polymorphonuclear leukocytes (PMNL) caused this elevation.

Methods: Eleven women in the first trimester of pregnancy were included in this prospective study.

Uterine artery embolization for management of interstitial twin ectopic pregnancy: case report.

Interstitial pregnancy is rare and dangerous variation of ectopic pregnancy. We describe a case of unilateral interstitial viable twin pregnancy treated by selective uterine artery embolization. A 23-year-old women with clinical and ultrasonic diagnosis of viable twin interstitial pregnancy was treated by selective uterine artery embolization after failure of systemic methotrexate treatment.

[Reforming the ambulatory care system--attitudes of patients and staff members].

Background And Objectives: The study aimed to examine the attitudes of patients and staff towards the reform the ambulatory healthcare by moving services from the hospital to the community.

Methodology: A cross-sectional study using a questionnaire was conducted during 2001 to examine the attitudes of patients and staff. The study took place in eight community clinics and eight hospital-based clinics and units where surgical activity took place.

Creatine kinase as a biochemical marker in diagnosis of placenta increta and percreta.

We describe 1 case of placenta increta and 1 of placenta percreta, both associated with elevated maternal serum creatine kinase concentration. In patients with placenta previa and ultrasonographic findings of an abnormally adherent placenta, an unexplained elevation in maternal serum creatine kinase level should alert the clinician to the possibility of placenta increta or placenta percreta, with an attendant increase in maternal morbidity.

Acceptability and skin reactions to transdermal estrogen replacement therapy in relation to climate.

The acceptability and skin reaction of Estraderm Transdermal Therapeutic Systems as a function of climatic variability were examined in various zones which alter considerably in their temperature and humidity. An open, noncomparative prospective study was carried out in four institutional out-patient menopausal clinics in varying climatic areas. Eighty symptomatic postmenopausal patients without previous estrogen replacement were examined.

Psychological development and blood levels of sex steroids in male identical twins of divergent sexual orientation.

Despite differences in psychological development and personality structure, blood levels of testosterone and estradiol were equivalent in two monozygotic male twins of divergent sexual orientation.